The Apothecary, a blog about health care and entitlement reform, is edited by Avik Roy, a Senior Fellow at the Manhattan Institute for Policy Research and a former health-care policy adviser to Mitt Romney. Avik also writes a weekly column on politics and policy for National Review.
The other contributors to The Apothecary are: Josh Archambault, Director of Health Care Policy at the Pioneer Institute in Boston; Robert Book of the American Action Forum; Chris Conover, Research Scholar in the Center for Health Policy and Inequalities Research at Duke University and an Adjunct Scholar at the American Enterprise Institute; Nicole Fisher of the University of North Carolina; John R. Graham of the Advanced Medical Technology Association; and Jeet Guram of Harvard Medical School.

The Obamacare Exchange Scorecard: Around 100,000 Enrollees And Five Million Cancellations

UPDATE: HHS has released the official numbers here. The HHS report states that only 26,794 people enrolled in the federal exchange—which amounts to 23 per state per day—and 79,391 enrolled in the state-based exchanges, for a total of 106,185.

In the market for individually-purchased health insurance, more than 4.8 million Americans have received notices that their preexisting plans are soon to be illegal, and will be cancelled. Many more cancellation notices are imminent. But yesterday, the Wall Street Journal obtained information regarding the number of people who have signed up for new private health coverage under Obamacare: “40,000 to 50,000” for the federal exchange, and 49,000 for 12 of the 14 state-based exchanges.

White House falls short of target by around 80%

Last month, the Associated Press published details of an internal Obama administration memo, dated September 5, detailing the White House’s monthly targets as to how many people would sign up for private insurance under Obamacare’s exchanges. “We expect enrollment in the initial months to be low,” said the September 5 memo. Through October, the administration estimated that 494,620 would sign up. They only got about a fifth of the way toward that lowball estimate.

“So far, private health plans have received enrollment data for 40,000 to 50,000 users of the federal marketplace,” write Christopher Weaver, Timothy Martin, and Louise Radnofsky in the Journal. “Separately, 12 of the 14 states that are running their own exchanges have tallied roughly 49,000 enrollees.”

Believe it or not, the enrollment data from the federal government may actually exaggerate the number of people who have signed up. “The number represents enrollment date sent to insurers from the marketplace,” but counts “data sent to insurers from the marketplace.”

One official told Amy Goldstein and Sarah Kliff of the Washington Post that “the official figure will include people who have paid for a plan and those who simply picked a plan and put it in their shopping cart.” Most private companies aren’t allowed to count as “sales” people who put items in their electronic shopping carts, but haven’t yet paid. But politics triumphs economics. Goldstein and Kliff write that, “according to one person with knowledge of the figures, slightly fewer than 40,000 people had selected a [federal exchange-based] health plan as of last week.”

Website unlikely to be ready by Nov. 30

Last Friday, in a briefing conducted by the Centers for Medicare and Medicaid services, officials walked back a previous commitment to get the website fixed by the end of November. “It’s a critical date, without question,” said one. “But don’t think of it as an unveiling date. The goal is to make significant improvements that day.”

These officials picked November 30 as their self-imposed deadline because, without it, many of the Americans seeing their preexisting plans cancelled before January 1 won’t be able to find Obamacare-compliant plans to replace them.

Juliet Eilperin and Amy Goldstein of the Washington Postreport that insurers may be looking for extra subsidies in order to help the government out. “One idea circulated within the insurance industry would be for HHS to approave a method to estimate subsidies and give preliminary tax credits based on those estimates—with the accurate amount determined later, once the system works better.” But “insurance industry leaders have said that they would insist on a guarantee that they would be compensated for any underpayments—and that they have asked to keep any overpayments.”

Fixing the website may take six months

Based on what we’ve seen to date from the administration, it appears likely that the website will take four to six months to function properly. The Obama administration should take the advice of the Democratic chairman of the Senate Finance Committee, Max Baucus (D., Mont.) and shut the thing down until they can fix it.

But the administration appears hell-bent on keeping the exchange open, because they want to enroll as many people into Obamacare before the President’s term is up. That way, the law will become harder to repeal, even if Republicans win in 2016.

I get the political logic. But Americans are facing significant disruptions in the quality and consistency of their health coverage. It’s this very mentality that caused the Obama administration to force-launch a website that wasn’t ready for prime time. It’s important for them to get it right.

INVESTORS’ NOTE: The biggest publicly-traded players in Obamacare’s health insurance exchanges are Aetna (NYSE:AET), Humana (NYSE:HUM), Cigna (NYSE:CI), Molina (NYSE:MOH), WellPoint (NYSE:WLP), and Centene (NYSE:CNC), in order of the number of uninsured exchange-eligible Americans for whom their plans are available.

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What that the international War Criminal George W. Bush is not the cause of the disastrous wars and economic shambles we are in. Go search for the President’s birth certificate because I know you are one of those conspiracy guys who think a black man in office can;t be born here. I am not defending his Bush like tactics and policies, but the heir to the throne of “ruining stuff” is G.W. Bush.

Can I ask to what mess you are referring? It is always astonishing how many otherwise intelligent people truly believe that the Bush administration and Republicans were solely responsible for the 2008 financial meltdown. The housing bubble began long before W took office, fueled by Greenspan’s artificially low interest rates and exacerbated by a relaxation in lending criteria initially under Clinton but continued under Bush. (Do you really think getting low wage earners into homes would have begun as a Republican initiative?) So we had an increase in subprime lending. Who was the poster child for subprime lending? Countrywide – who was in Democratic Senator Chris Dodd’s pocket, allowing him below market refinancing rates because he was a friend of the CEO. Then those loans got securitized and got AAA credit ratings from the rating agencies before being sold off to investors – it was not until 2006 (under GW Bush) that the Credit Agency Reform Act was passed granting the SEC oversight. Until then, apparently no one saw any potential conflicts of interest with rating agencies being paid by the companies whose securities were being rated. Fannie Mae and Freddie Mac played a role as well, as both entities were pushed hard by Congress to further expand lending (including subprime). Despite the Bush administration’s repeated warnings and attempts to create a new regulator (as early as 2002) to oversee Fannie and Freddie, Democrats in Congress blocked the initiative. Democratic Congressman Barney Frank said repeatedly (you can see the videos on YouTube – just look up “Barney Frank Fannie Mae) as late as 2005 that concerns about Fannie and Freddie were overblown, and there was no evidence of a housing bubble. In an ABC interview, Bill Clinton criticized Democrats for pushing back against him during his term and against Republicans generally who wanted to tighten up regulations on Fannie and Freddie (this is also on YouTube). And what about those Credit Default Swaps that AIG (among others) sold as insurance against those securities? The Feds had limited oversight of those Over-the-Counter (OTC) derivatives due to the Commodity Futures Modernization Act, signed into law by Bill Clinton in 2000.

So, while we all concede that Bush was at the helm when the proverbial s**t hit the fan, does anyone really believe that Democrats did not contribute to the mess? The meltdown was a long term result caused by both sides of the aisle. Until we can get past that and stop finger pointing, this country is going nowhere good.